An evaluation of the reclassification of ophthalmic chloramphenicol for the management of acute bacterial conjunctivitis in community pharmacies in Western Australia

Abstract

© 2014 Royal Pharmaceutical Society. Objective The study aims to evaluate factors influencing pharmacists' management of eye infections following the reclassification of ophthalmic chloramphenicol to pharmacist supply. Methods Data were collected using a self-administered questionnaire posted to a random sample of community pharmacies in urban and rural areas in Western Australia. Data were entered into Excel and analysed using SPSS v17 (SPSS Inc., Chicago, IL, USA) and SAS v9.2 (SAS Institute Inc., Cary, NC, USA). Descriptive statistics were used to summarise the responses and demographics of respondents. Regression analysis was used to identify relationships between variables. Factor analysis was conducted to pool variables and the derived factors were subjected to regression analysis. Key findings Of the 240 community pharmacies surveyed, 119 (49.5%) responded (79% urban and 21% rural pharmacies). Urban and rural pharmacies provided ophthalmic chloramphenicol over-the-counter (OTC) 3-4 and 1-2 times weekly, respectively (P-=-0.021), with some pharmacies providing 12 or more per week. Over 82% of respondents claimed that sales of other OTC products used for acute bacterial conjunctivitis had 'decreased/decreased markedly'. A majority of respondents (59%) claimed that there was no change in the number of prescriptions received for ophthalmic chloramphenicol. Most respondents (76.4%) agreed/strongly agreed that pharmacist's current level of training was adequate to provide ophthalmic chloramphenicol. However, approximately one-fifth (21.8%) responded that pharmacists required some additional training. Conclusions Down-scheduling of ophthalmic chloramphenicol has improved pharmacists' capability to treat acute bacterial conjunctivitis, largely as a replacement for products previously available OTC, rather than fewer general practitioner consultations. Pharmacists showed overall support for the reclassification as it enabled better use of professional skills and patient access to improved treatment options.